{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:54:24Z","timestamp":1783997664679,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP 19K17026"],"award-info":[{"award-number":["JP 19K17026"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Myasthenia gravis (MG) is an autoimmune disease affecting the neuromuscular junction (NMJ) of skeletal muscle. Complement activation is one of the mechanisms by which anti\u2013acetylcholine receptor (anti\u2010AChR) autoantibodies reduce synaptic transmission at the NMJ. In this study, we aimed to examine the activation of the complement pathways, including the classical pathway, as potential contributors to the pathogenesis of MG with anti\u2010AChR antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010center, observational study of 45 patients with anti\u2010AChR\u2013antibody\u2010positive generalized MG, serum concentrations of major components of the complement pathways, including C1q, C5, C5a, soluble C5b\u20109 (sC5b\u20109), Ba, and complement factor H, were measured using an enzyme\u2010linked immunosorbent assay. A total of 25 patients with a non\u2010inflammatory neurological disorder served as controls. In addition, the relationships of complement activation with clinical characteristics were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients with MG exhibited lower serum levels of C5 (<jats:italic>p<\/jats:italic>\u2009=\u2009.0001) and higher serum levels of sC5b\u20109 (<jats:italic>p<\/jats:italic>\u2009=\u2009.004) compared with the control group. At about 6\u2009months (range, 172\u2013209\u2009days) after the start of immunotherapy, serum levels of Ba were significantly higher than baseline levels (<jats:italic>p<\/jats:italic>\u2009=\u2009.002) and were associated with improvement in MG clinical scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Herein, we provide evidence for the activation of the classical complement pathway and its association with disease activity in anti\u2010AChR\u2013antibody\u2010positive generalized MG.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27973","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T13:04:40Z","timestamp":1694696680000},"page":"798-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Activation of the classical complement pathway in myasthenia gravis with acetylcholine receptor antibodies"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2586-6949","authenticated-orcid":false,"given":"Yukiko","family":"Ozawa","sequence":"first","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9252-1863","authenticated-orcid":false,"given":"Akiyuki","family":"Uzawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manato","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"},{"name":"Department of Neurology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70063-8"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-198003000-00005"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00262"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.70"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13522"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1515\/revneuro-2014-0021"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14500"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.156"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_11_11_1","article-title":"Complement activation profile in myasthenia gravis patients: perspectives for tailoring anti\u2010complement therapy","volume":"10","author":"Iacomino N","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen3.12180"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002864"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.140.8.2589"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.immunol.23.021704.115835"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286420935697"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2008.03.007"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2005.11.005"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-019-01068-2"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/13543784.2021.1897567"}],"container-title":["Muscle &amp; 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